Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 06921 | Date 06/09/2022 |
| Token No | SM/22-23/5008 08/09/2022 | Serial | 027 |
| Patient Name | Mr. SURESH SHA | Contact No | 6289773245 |
| Address | 2 MAIDA PATTY LANE | Age | 62 Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||